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Indian Health Service The Federal Health Program for American Indians and Alaska Natives


     Indian Health Manual
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Part 1, Chapter 4:  Manual Appendix 1-4-A

Statement of Organization and Functions

INDIAN HEALTH SERVICE (G)

G. 10., Organization.  The Indian Health Service (IHS) is under the direction of a Director who is responsible to the Secretary of Health and Human Services.  The IHS consists of the following major components:

 Office of the Director (GA),
 Office of Management Support (GAA),
 Office of Public Health (GAB), and
 IHS Area Offices (GF).

Office of the Director (GA).  Provides overall direction and leadership for the IHS by:   (1) Establishing goals and objectives for the IHS consistent with the mission of the IHS; (2) providing leadership during the development of health care policy; (3) providing leadership to ensure the delivery of quality comprehensive health services; (4) coordinating the IHS activities and resources internally and externally with the activities and available resources of other governmental and nongovernmental programs, promoting optimum utilization of all available health resources; (5) advocating for the health needs and concerns of American Indians and Alaska Natives (AI/AN) and promoting the IHS programs at the local, State, national, and international levels; (6) developing and demonstrating alternative methods and techniques of health services management and delivery with maximum participation by Indian tribes and Indian organizations; (7) supporting the development of individual and tribal capacities to participate in Indian health programs through means and modalities that they deem appropriate to their needs and circumstances; (8) affording Indian people an opportunity to enter a career in the IHS by applying Indian preference; (9) disseminating information to IHS consumers and the general public regarding the activities of the IHS and the health status of AI/AN people and communities; and (10) ensuring full application of the principles of Equal Employment Opportunity laws and the Civil Rights Act in managing the human resources of the IHS.

Urban Indian Health Programs Staff.  (1) Advises the Director, IHS, on the activities and issues related to the IHS implementation of Title V of the Indian Health Care Improvement Act, as amended; (2) develops and recommends policies, administrative procedures and guidelines for IHS services and activities for urban Indian health programs and organizations; (3) assures that urban Indian health programs and organizations are informed of pertinent health policy and that consultation with urban Indian health programs and organizations occurs during the development of IHS policy; (4) supports urban Indian health programs and organizations in managing health programs and coordinates support available from other public and private agencies and organizations; (5) advises the Director, IHS, on agency compliance to urban Indian health program policies, administrative procedures and guidelines; (6) maintains relevant information on urban Indian health programs and organizations; and (7) coordinates meetings and other communications with urban Indian health program representatives.

Congressional and Legislative Affairs Staff  (1) Is the principal advisor to the Director, IHS, on all legislative and congressional relations matters; (2) advises the Director and other IHS officials on the need for changes in legislation and manages the development of IHS legislative initiatives; (3) serves as the IHS liaison office for congressional and legislative affairs with congressional offices, the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), other Federal agencies, and the White House; (4) tracks all major legislative proposals in Congress that would impact on Indian health and ensures that the Director and appropriate IHS and HHS officials are briefed on potential impact of proposed legislation; (5) represents the IHS in discussions regarding policy, legislative initiatives/implementation and provides technical assistance and advice relative to the effect initiatives/implementation would have on the IHS; (6) collaborates with the Office of Management Support and the Office of Public Health on programmatic and financial issues related to budget formulation; (7) coordinates the preparation and IHS internal review and clearance process for the Agency Congressional Budget Justification at the Department level; (8) conducts the legislative analysis, and provides support and liaison to the Director relative to IHS appropriations efforts; (9) directs the development of IHS briefing materials for congressional hearings, testimony, and bill reports; (10) analyzes legislation for necessary action within the IHS, and develops appropriate Legislative Implementation Plans; and (11) provides leadership, advocacy, and technical support to respond to requests from the public, including tribal governments, tribal organizations, and Indian community organizations regarding IHS legislative issues.

Policy Support Staff.  (1) Coordinates the review and analysis of policy-related issues, and advises the Director, IHS, of options for resolving problems caused by existing or proposed IHS policy; (2) forecasts the costs, benefits, and long-term results of policy options; (3) assures IHS policies are consistent and do not conflict; (4) provides leadership on behalf of the Director to functional area managers at IHS Headquarters in developing or modifying and overseeing the implementation of IHS policies and procedures; (5) organizes, facilitates, and supports stakeholder task teams to advise the Director on major policy issues; (6) completes special assignments for the Director that may require coordination with other IHS offices or other Federal agencies, tribes, or tribal organizations; (7) serves as the IHS liaison for intergovernmental and private sector initiatives that impact health care services and management of the IHS, and participates on intergovernmental task forces; (8) represents the Director in meetings with IHS employees and high-level management officials within the IHS, the HHS, or other Federal agencies, tribes, and other organizations; (9) provides staff support to the Director, including preparation of presentations and briefings; and (10) provides staff support to the Council of Area and Associate Directors (the Council), the Executive Leadership Group of the Council, and other standing committees of the Council.

Public Affairs  (1) Is the principal advisor to the Director, IHS, for strategic planning on communications, media relations, and public affairs policy formulation and implementation and for assuring that IHS policy is consistent with directives from the Assistant Secretary for Public Affairs; (2) establishes and implements policy for the internal and external dissemination of Agency information; (3) is the central focus office for technical guidance and assistance to IHS staff for the development of internal and external communications, media relations, and public affairs activities; (4) coordinates the IHS communications and public affairs activities with other public and private sector organizations; and (5) coordinates the clearance of IHS public relations activities and communications materials.

To provide for the full participation of Indian tribes in the programs and services provided by the Federal Government, and to ensure that the responsibilities of the United States are not waived, modified, or diminished, in any way with respect to Indian tribes and individual Indians, by any grant, contract, compact, or funding agreement awarded by the IHS under the Indian Self-Determination and Education Assistance Act, as amended, the:

Office of Tribal Self Governance (GA-1)  (1) Develops and oversees the implementation of Tribal self-governance legislation and authorities in the IHS, under Title III of the Indian Self Determination and Education Assistance Act, as amended; (2) develops and recommends policies, administrative procedures, and guidelines for self-governance tribal activities, with maximum input from IHS staff and workgroups, tribes and tribal organizations, and the Tribal Self Governance Advisory Committee; (3) advises the Director on Agency compliance with self-governance policies, administrative procedures and guidelines and coordinates activities for resolution of problems with appropriate IHS and HHS staff; (4) provides technical assistance and support in the development of the Tribal Self-Governance Demonstration Project; (5) participates in the reviews, and recommends approval, of proposals from tribes for self-governance planning and negotiation grants; (6) oversees the negotiation of self-governance compacts and annual funding agreements with participating tribal governments; (7) in conjunction with IHS Area and Headquarters components, identifies the amount of Area office and Headquarters managed funds necessary to implement the annual funding agreements and prepares annual budgets for available tribal shares; (8) coordinates semi-annual reconciliation of funding agreements with IHS Headquarters components, Area offices, and participating tribes; (9) is the principal IHS office for developing, releasing, and presenting information on behalf of the IHS Director related to the IHS tribal self-governance activities to tribes, tribal organizations, HHS officials, IHS officials, and officials from other Federal agencies, State and local governmental agencies, and other agencies and organizations; (10) arranges national self-governance meetings to promote the participation by all AI/AN tribes in IHS self-governance activities and program direction; and (11) coordinates meetings for self governance tribal delegations visiting IHS Headquarters.

And, the

Office of Tribal Programs (GA 2)  (1) Advises the Director, IHS, on the activities and issues related to IHS' implementation of self determination under Title I of the Indian Self Determination and Education Assistance Act, as amended; (2) develops and recommends policies, administrative procedures, and guidelines for a range of IHS services and activities for Title I tribes and direct service tribes, and advises the Director of the effect they have on health programs; (3) assures that Indian tribes and Indian organizations are informed, regarding pertinent health policy and program management issues, and that consultation and participation by tribes and Indian organizations occurs during the development of IHS policy; (4) administers the Tribal Management Grant Program to assist tribes in developing and strengthening their capabilities in managing health programs; (5) supports Title I tribes in managing health programs and coordinates support available from other public and private agencies and organizations; (6) advises the Director, IHS, on Agency compliance to IHS self determination program policies, administrative procedures, and guidelines; (7) coordinates implementation of special Indian legislation and authorities; (8) maintains relevant information on Indian tribes and programs, and IHS tribal self determination policies; (9) coordinates meetings and other communications with non-self-governance tribal delegations; and (10) is the principal IHS office for developing, releasing, and presenting information on behalf of the IHS Director related to the IHS tribal self-determination activities to tribes, tribal organizations, HHS officials, IHS officials, and officials from other Federal agencies, State and local governmental agencies, and other agencies and organizations.

Equal Employment Opportunity and Civil Rights Staff (GA-3)  (1) Administers the IHS equal employment opportunity, civil rights, and affirmative action programs, in accordance with applicable laws, regulations, and HHS policies; (2) plans and oversees the implementation of IHS affirmative employment and special emphasis programs; (3) reviews data on IHS employee personnel actions and advises IHS managers of discriminatory trends; (4) ensures immediate action on complaints of alleged sexual harassment or discrimination on the basis of sexual orientation; (5) decides on accepting, for investigation, or dismissing discrimination complaints and evaluates accepted complaints for procedural sufficiency and investigates, adjudicates, and resolves such complaints; and (6) develops EEO education and training programs for IHS managers, supervisors, counselors, and employees.

Office of Management Support (GAA)  .  (1) Provides advice and support to the Director and IHS managers on administrative and management regulations, policies, and procedures; (2) provides IHS-wide leadership, guidance, and support in the management of financial, human, personal property, supply, and information resources; (3) formulates, administers, and supports IHS-wide policies, delegations of authority, and organizations and functions development; (4) provides leadership, direction, and coordination of activities for continuous improvement of management accountability and administrative systems and for effective and efficient program support services IHS-wide; (5) administers a program for assuring the integrity of IHS employees in performance of their official duties and responsibilities that conforms with applicable laws, regulations, and guidance from within the Department and from other Federal oversight agencies, and directs the process for personnel security and suitability in the IHS; (6) ensures the accountability and integrity of acquisition and grants management, personal property utilization, and disposition of IHS resources; (7) assures that the IHS management services, policies, procedures, and practices support IHS Indian Self Determination policies; (8) administers the control and quality of IHS reports, correspondence, and publications charged to Headquarters' officials for internal or external dissemination, including regular and special reports required by the Department and the Congress; (9) advises the Director on statutory and regulatory issues related to the IHS and coordinates resolution of IHS legal issues with the Office of the General Counsel (OGC), IHS staff, and other Federal agencies; (10) provides leadership and advocacy of the IHS mission and goals with the Department, Administration, Congress, and other external authorities; (11) assures that IHS appeal systems meet legal standards; (12) assists in the assurance of Indian access to State, local, and private health programs; (13) manages IHS compliance with ethics requirements including the Federal Managers Financial Integrity Act; and (14) assures that access to IHS records meet statutory requirements.

Program Integrity and Ethics Team.    .  (1) Directs the investigation and resolution of allegations of impropriety, mismanagement of resources, abuse of authority, violations of Standards of Conduct, or other forms of wrongdoing or mismanagement; (2) formulates plans and provides leadership, guidance, and evaluations for the IHS Personnel and Physical Security programs; (3) provides focus for IHS-wide management investigative capability for hotline cases; (4) provides focus for management of the IHS-wide Ethics program; (5) develops and recommends policies and procedures related to employee ethics, financial interests, and outside activities; (6) advises IHS management of appropriate corrective and remedial actions to be taken on investigatory findings and recommendations; and (7) provides management focus and guidance for the IHS-wide employee drug testing program.

Executive Secretariat (GAA-1).  (1) Reviews, analyzes, and coordinates correspondence received by the IHS Office of the Director (OD); (2) assigns and controls required correspondence followup action by appropriate functional areas at IHS Headquarters and Areas; (3) assigns, controls, and tracks reports required by the Congress; (4) ensures the quality of correspondence, reports, and publications from IHS Headquarters and Area offices that require signature by IHS OD for internal and external distribution; (5) conducts training to promote conformance by IHS Headquarters and Area staff on the IHS Executive Correspondence Guidelines, other good correspondence practices, and/or the requirements of higher echelon organizations; (6) maintains an automated document tracking system to assist in timely processing of internal and external correspondence; (7) maintains official records for OD correspondence and conducts topic research of files, as needed; (8) writes, develops, prepares, and coordinates documents for IHS OD signature; (9) coordinates the review of policy issues that surface in prepared responses or initiatives and resolves differences; and (10) ensures accurate flow of correspondence and related information to tribes, tribal organizations, heads of Federal Government departments and agencies, congressional staff offices, and members of Congress.

Management Policy Support Staff (GAA-2).  (1) Provides analysis, advisory, and assistance services to IHS managers and staff for the development, clearance, and filing of IHS directives and delegations of authority; (2) serves as principal advisor and source for technical assistance for establishment or modification of organizational infrastructures, functions, and Standard Administrative Code configurations; (3) administers a program for assuring IHS' compliance with management control requirements in the Federal Managers' Financial Integrity Act; (4) coordinates the development, clearance, and transmittal of IHS responses and followup to reports issued by the Office of Inspector General (OIG), the General Accounting Office (GAO), and other Federal internal and external authorities; and (5) provides assistance and support to special assigned task groups, and conducts special program or management integrity reviews as required.

Division of Administrative Support (GAA1).  Plans, develops and directs program support and general services programs; (2) develops and disseminates policy and procedural guidelines for uniform administrative services and practices; (3) provides guidance and support to IHS Headquarters and field in the development, planning, and implementation of administrative functions; (4) maintains liaison with Department and General Services Administration (GSA) on logistics issues affecting the IHS; (5) monitors, evaluates, and reports on administrative programs and services; (6) provides advice and technical assistance on design and layout, inventories, and print order tracking for IHS publications; and (7) manages a variety of special projects.

Office Services Team.  (1) Administers office, supply, and space management services for Headquarters; (2) develops and disseminates policy and procedural guidelines for uniform office service programs; (3) provides leadership and coordination in planning, development, operation, and evaluation of special office support programs in small purchase acquisitions, GSA supplies, equipment, furniture, communications, transportation, mail management, photocopying, and printing; and (4) manages motor vehicles, personal property, and special projects and interagency activities.

Personal Property Management Team  (1) Plans, develops, and administers the IHS policies on personal property management in conformance with Federal personal property management laws, regulations, policies, procedures, practices, and standards; (2) interprets regulations and provides advice on execution and coordination of personal property management policies and programs; (3) develops and recommends policies and procedures for the protection and disposition of IHS records and oversees the evaluation of Records Management activities in the IHS; (4) administers management systems and methods for planning, utilizing, and reporting on administrative personal property management programs, including the IHS personal property accountability and controls systems; (5) provides guidance and serves as principal administrative authority on Federal personal property management laws, regulations, policies, procedures, practices, and standards; (6) conducts surveys and studies involving evaluation and analysis of the personal property management activities IHS-wide; (7) maintains liaison with the Department and the GSA on personal property management issues and programs affecting the IHS; and (8) prepares reports on IHS personal property and develops statements for annual budget formulation and presentation.

Division of Financial Management (GAA2).  (1) Develops and prepares the budget for the Office of Management and Budget (OMB) submission and the President's budget for the Indian Health Service and Facilities Appropriation; (2) participates with Department officials in budget briefings for the OMB and Congress; (3) distributes, coordinates, and monitors resource allocations; and (4) in collaboration with the Headquarters officials and the tribes, develops and implements budget, fiscal, and accounting procedures and conducts reviews and analyses to ensure compliance in budget activities.

Budget Formulation and Presentation Branch (GAA21).  (1) Interprets policies, guidelines, manual issuances, OMB circulars, and instructions of Congress, the OMB, the Department, and IHS on formulation of preliminary, formal, and congressional budget requests for the IHS and Indian Health Facilities appropriation requests; (2) directs the collection, review, and analysis of program and financial data from the Area Offices, tribes, and tribal organizations to determine resource requirements; (3) prepares witness information for hearings before the House and Senate Appropriation Committees, House Committee on Interior and Insular Affairs, the Senate Committee on Indian Affairs, and other congressional committees as requested; (4) coordinates development of responses and inserts to be used for the record by and for congressional appropriations hearings; (5) coordinates development of briefing materials in response to congressional concerns and hearings; and (6) develops, implements, and maintains IHS policies and procedures for congressional budget liaison activities.

Budget Execution Branch (GAA22).  (1) Interprets policies, guidelines, and directives from Congress, OMB, GAO, Treasury, the Department, and IHS on budget execution; (2) recommends and coordinates IHS Area Budget Execution; (3) prepares apportionment requests for the IHS and Indian Health Field appropriations; (4) consults with the Headquarters officials on Area funding allocations; (5) maintains fund control; (6) establishes and maintains IHS Headquarters memorandum-accounts-of-obligations; and (7) prepares reprogramming requests. Systems Review Analysis Branch (GAA23).  (1) Interprets policies, guidelines, and manual issuances of Congress, Treasury, GAO, the Department, and IHS on systems of fiscal management; (2) plans, directs, and implements fiscal policies and procedures on Headquarters and field accounting; (3) coordinates the cost accounting system in the IHS; and (4) conducts reviews and analysis of accounting and financial management operating systems.

Division of Acquisition and Grants Management (GAA3).  (1) Develops, recommends, and oversees the implementation of policies and procedures and delegations of authority for the acquisition and grants management activities in the IHS, including self-governance compacts, consistent with applicable regulations, directives, and guidance from higher echelon in the Department and Federal government oversight agencies; (2) executes and administers contracts for IHS Headquarters, grant awards IHS-wide, and assists in acquisition and grants operations at field components as required; (3) evaluates compliance with acquisition and grants management related directives at IHS Headquarters and Area offices and oversees actions required to correct identified weaknesses; (4) provides cost advisory and audit resolution services in accordance with applicable statutes and regulations; (5) advises the Director, Office of Management Support, of proposed legislation, regulations, and directives that affect contracts and financial assistance programs in the IHS; (6) manages the IHS acquisition and grant information systems and conducts analysis of data for reports and/or responses to inquiries from internal and external authorities; (7) conducts training and provides advice and technical consultation for contracts and grants policies and procedures to IHS Headquarters and field components; (8) coordinates the IHS Small, Disadvantaged, and Women-Owned Business programs and oversees compliance with the Buy Indian Act; (9) is the IHS contact point for contract protests, and to the Department and the GAO regarding contract-related issues; (10) administers the agency agreements program in the IHS; and (11) coordinates the collection of disallowed costs cited in reports of contractor and grantee audits.

Acquisitions Management Branch (GAA31).  (1) Develops and recommends policies and procedures for acquisition operations in the IHS; (2) Provides advice, technical consultation, and training to IHS Headquarters and field operations staff; (3) reviews and makes recommendations for approval/disapproval of contract-related documents such as: pre- and post-award documents, unauthorized commitments, procurement planning documents, Justification for Other Than Full and Open Competition, waivers, deviations, and determinations and findings that require action by the Agency Principal Official Responsible for Acquisition, the Agency Head of Contracting, or the Office of the Secretary; (4) executes and administers contracts for IHS Headquarters and field components as authorized; (5) conducts compliance reviews of all IHS procurement operations, including tribal contracting activities, and recommends and oversees completion of necessary corrective actions; (6) processes unsolicited proposals for the IHS; (7) serves as IHS Bid Protest/Mistake in Bid control point; (8) develops and oversees compliance to policies and procedures for use of the International Merchant Purchase Acquisition Card in the IHS; (9) manages the Department acquisition training and certification and the project officer training programs in the IHS; (10) reviews, recommends, and issues delegations of acquisition authority in the IHS; and (11) supports and maintains the IHS Contract Information System and controls entry of data into the HHS Contract Information System.

Grants Management Branch (GAA32).  (1) Awards and administers grants, compacts, and cooperative agreements for IHS financial assistance programs; (2) develops, recommends, and oversees the implementation of grant and compact-related policy and procedures; (3) manages the Department Grants Training and Certification programs for IHS and reviews and recommends delegations of authority to grants and compact officials in the IHS; (4) conducts oversight compliance reviews of IHS grants operations including compacts, and recommends and oversees completion of necessary corrective actions; (5) reviews and makes recommendations for improvements in grantee and potential grantee management systems; (6) is the IHS liaison with Congress, the Department, and the public for grants and other financial assistance programs within the IHS; (7) maintains the Catalog of Federal Domestic Assistance for IHS financial assistance programs; (8) conducts grants-related training for IHS staff, grantees, and potential grantees; (9) coordinates payment to grantees including scholarship recipients; and (10) establishes and maintains the IHS automated Grants Information System and controls data entry into the HHS Grants Management Information System.

Division of Human Resources (GAA4).  (1) Advises the Director, IHS, on personnel management issues, programs and policies for Civil Service and Commissioned Corps personnel programs; (2) assures implementation of the Indian Preference policy in all personnel practices; (3) develops personnel management policies, programs, and reports in accordance with applicable laws, regulations, and policies;(4) provides personnel management and services throughout IHS, to include, but not limited to, manpower planning and utilization, staffing, recruitment, compensation and classification, human resource development, pay administration, labor, and employee relations; (5) provides advice, consultation; and assistance to IHS management and tribal officials on tribal health program personnel policy issues; (6) provides technical support, guidance, and assistance on all personnel programs to IHS Headquarters operations and other organizations as necessary; (7) provides liaison for IHS commissioned corps activities with the Department Division of Commissioned Personnel; and (8) represents IHS in all personnel management matters.

Human Resources Advisory team.  (1) Plans, conducts, and evaluates personnel functional programs; (2) develops IHS personnel policies, programs, and reports; (3) provides personnel program and policy advice and assistance throughout IHS; (4) provides advice and assistance to IHS management and tribal officials on tribal health program personnel policies; and (5) develops and implements Indian Preference policies and procedures.

Human Resources Operations Team  (1) Plans and implements personnel servicing responsibilities for IHS programs covered by the headquarters appointing authority, including staffing, recruitment, classification, pay administration, and employee relations; (2) provides staff support for the establishment and recruitment of Senior Executive Service positions including performance management, compensation and award nominations; (3) processes personnel actions and appoints all civil service employees; and (4) provides advice and training on timekeeping and pay administration.

Commissioned Personnel Support Team.  (1) Acts as the liaison between IHS and the Program Support Center, Division of Commissioned Personnel, HHS; (2) advises the Director, IHS supervisors, administrators and managers, officers and dependents on commissioned personnel benefits, policies, procedures, regulations, as the IHS primary point of contact for commissioned personnel management; (3) develops policies, procedures, and recommendations to the Division of Commissioned Personnel; and (4) produces resource materials and conducts training sessions on commissioned personnel issues for officers, supervisors, and commissioned personnel specialists in IHS Area Offices.

Division of Information Technology Support (GAA5).  (1) Advises the Director, IHS, on all aspects of information management; (2) directs the development and implementation of policies, procedures, and standards for information management activities and services in the IHS; (3) directs the design, development/purchase, implementation, and support of information systems and services used in the IHS; (4) provides information technology services and support to IHS, tribal, and urban Indian health programs; and (5) represents the IHS to, and enters into information technology agreements with, Federal, tribal, State, and other organizations.

User Support Team.  (1) Designs, develops/purchases, implements and supports information systems and services used in IHS Headquarters; and (2) provides information technology services and support to IHS Headquarters.

Information Technology Support Center (GAA51).  (1) Develops and implements policies, procedures, and standards for information management activities and services in the IHS; (2) designs, develops/purchases, implements, and supports information systems and services used in the IHS; (3) provides information technology services and support to IHS, tribal, and urban Indian health programs; and (4) represents the IHS to Federal, tribal, State, and other organizations.

Self-Determination Services Team.  (1) Develops policies and related materials to support tribal operation of information management activities and services; and (2) represents the IHS to tribal and other organizations.

Applications Software Development and Support Team.  (1) Designs, develops/purchases, implements and supports application software and related services used in the IHS; (2) provides application software services and support to IHS, tribal, and urban Indian health programs; and (3) represents the IHS to Federal, tribal, State, and other organizations.

Telecommunications Management Team.  (1) Develops and implements policies, procedures, and standards for telecommunication services in the IHS; (2) designs, develops/purchases, implements and supports telecommunication services used in the IHS; (3) provides telecommunication services and support to IHS, tribal, and urban Indian health programs; and (4) represents the IHS to Federal, State, and other organizations.

Computer Systems Management Team.  (1) Develops and implements policies, procedures, and standards for computer systems management activities and services in the IHS; (2) designs, develops/purchases, implements, and supports computer systems and services used in the IHS; (3) provides computer systems services and support to IHS, tribal, and urban Indian health programs; and (4) represents the IHS to Federal, tribal, State, and other organizations.

Division of Regulatory and Legal Affairs (GAA6).  (1) Manages the IHS' overall regulations program and responsibilities, including determining the need for and developing plans for changes in regulations, developing or assuring the development of needed regulations, and maintaining the various regulatory planning processes; (2) provides all IHS liaison with the Office of the Federal Register on matters relating to the submission and clearance of documents for publication in the Federal Register; (3) assures proper agency clearance and processing of Federal Register Documents; (4) informs management and program officials of regulatory activities of other Federal agencies; (5) manages the IHS review of non-IHS regulatory documents that impact the delivery of health services to Indians; (6) advises the Director and serves as liaison with the Office of the General Counsel (OGC) on such matters as litigation, regulations, and related policy issues; (7) determines need for and obtains legal clearance of IHS directives and other issuances; (8) coordinates legal issues with the OGC, IHS, HHS components, and other Federal agencies, including the identification and formulation of legal questions, and advising on the implementation of OGC opinions; (9) assures that IHS' appeals processes meet legal standards; (10) advises on and participates in Indian Self Determination and Education Assistance Act appeals and hearings; (11) provides guidance and assistance on State and Federal health reform efforts, including access and civil rights aspects and State Medicaid waiver applications; (12) advises on the administration of the contract health services (CHS) appeals system and is a participant with the Office of Public Health in the Director's CHS appeal decisions; and (13) manages the retrieval and transmittal of information in response to requests received under the Freedom of Information Act (FOIA) or the Privacy Act, and ensures the security of IHS documents used in such responses that contain sensitive and/or confidential information.

Regulations and Records Access Team  (1) Manages the Agency's regulation program and responsibilities; (2) provides liaison with the Office of the Federal Register; (3) advises on the need for or changes in current regulations; (4) develops or assures the development of IHS regulations; (5) keeps IHS officials informed on relevant regulatory activities of other agencies of the Government; (6) coordinates regulations activities with agencies within the Department that impact on the delivery of health services to Indians; (7) maintains and updates the various regulatory agendas; (8) assures that all IHS materials for publication in the Federal Register are properly cleared, processed, and in proper format; (9) manages the retrieval, review, and appropriate transmittal of information in response to Freedom of Information Act (FOIA) requests including ensuring the appropriate security of such documents; and (10) coordinates the implementation and the application of Privacy Act requirements.

Legal Affairs Team.  (1) Coordinates the resolution of and the development of legal advice to the Director on IHS legal issues with the OGC, IHS senior staff, and other Federal agencies; (2) provides liaison with the OGC in such matters as litigation, regulations, legislation, policy review, civil rights, and administrative appeals; (3) provides advice on the development and implementation of non-personnel appeals processes to assure they meet legal standards; (4) maintains and distributes the Compendium of Legal Opinions; (5) reviews IHS directives and other issuances for needed legal clearances; (6) advises on the impact on IHS and the Indian community of State and Federal health reforms; and (7) provides policy review and advice on the need for or application of legal opinions.

Division of Health Professions Support (GAA7).  (1) Develops the IHS program to recruit, select, assign, and retain health care professionals, in accordance with policies and guidance provided by the Division of Human Resources; (2) assesses IHS professional staffing needs; (3) provides research and analysis functions for Chief Medical Officers, Clinical Directors, and senior clinicians; (4) manages and supports health professions education programs and activities; and (5) develops and administers Indian Health Professions programs authorized by the Indian Health Care Improvement Act (IHCIA), as amended.

Health Professions Support Team.  (1) Develops and implements IHS programs to recruit, select, assign, and retain health care professionals and coordinates these activities respective disciplines; (2) assesses professionals staffing needs and coordinates the development of strategies and systems to satisfy these needs; (3) coordinates the planning and development of IHS strategies and systems to improve the morale and retention of all professionals; (4) coordinates Headquarters activities for physician residency and training programs; (5) coordinates the IHS National Health Service Corps (NHSC) program, including liaison and assignment of NHSC scholarship recipients to IHS; (6) develops priority sites for the loan repayment program; (7) responsible for coordinating placement of loan repayment physicians; (8) serves as IHS coordinator for pre-medical and medical school IHS scholarship recipients; (9) retrieves, establishes, and manages information and data on the IHS work force; and (10) conducts work force data analyses, including trends and projections, identifying work force needs by major personnel systems, categories, and disciplines.

Loan Repayment Branch (GAA71).  (1) Awards, monitors, places (in IHS, tribal, and urban sites), and processes waivers and defaults of participants in the Loan Repayment Program (LRP) as mandated by Section 108 of the IHCIA; (2) coordinates the LRP payment and debt management function with the Program Support Center; and (3) coordinates program administration with the IHS Area office and Service Unit personnel, particularly placement activities, including Clinical Directors, Chief Medical Officers, and professional recruiters.

Scholarship Branch (GAA72).  (1) Develops, administers, and evaluates programs in the IHS Scholarship Program authorized under the IHCIA: Section 102 (Health Professions Recruitment Program for Indians), Section 103 (Health Professions Preparatory Scholarship Program for Indians), Section 104 (Indian Health Professions Scholarship Program), Section 105 (IHS Externs Program), Section 120 (Matching Grants to Tribes for Scholarship Programs), Section 217 (Indians Into Psychology Program), and other funded programs authorized under the IHCIA.

Office of Public Health (GAB).  (1) Advises and supports the Director, IHS, on policy, budget formulation, and resource allocation regarding the operation and management of IHS direct, tribal and urban public health programs, quality assurance, and self-determination; (2) provides agency-wide leadership and consultation to IHS direct, tribal, and urban public health programs on IHS goals, objectives, policies, standards, and priorities; (3) represents the IHS within the HHS and external organizations for purposes of liaison, professional collaboration, cooperative ventures, and advocacy; (4) manages and provides national leadership and consultation for IHS and Area Offices on strategic and tactical planning, program evaluation and assessment, public health and medical services, research agendas, and special public health initiatives for the agency; (5) manages the design, development, and assessment, for facilities implementation of resource requirements and resource allocation methodology models for the agency; (6) carries out IHS responsibilities as required by the United States Federal Response Plan under Emergency Support Function No. 8 (7) assures agency compliance with the Code of Federal Regulations 45, Part 46, Protection of Human Subjects; and (8) administers the functions related to clinical services, managed care, hospitals and ambulatory care centers, community and environmental health and facilities and environmental engineering.

Division of Clinical and Preventive Services (GAB1).  (1) Serves as the primary source of technical and policy advice for IHS, and Area Offices and IHS direct, tribal, and urban public health programs on the full scope of clinical health care programs, including their quality assurance and preventive aspects, and tort claims; (2) provides leadership in articulating the clinical needs of the AI/AN population and competing health care needs; (3) advocates the resource needs of specialized health care delivery providers of clinical services disciplines; (4) provides consultation and technical support to IHS direct, tribal, and urban public health programs including, but not limited to, alcohol and substance abuse, dental services, diabetes and other chronic disease prevention, emergency medical services training and material support, mental health, nutrition services training and education, services for children with special needs, and sensory disabilities services; and (5) administers the program functions that include, but are not limited to, alcohol and substance abuse, chronic disease such as diabetes and cancer, clinical engineering, dental services, emergency medical services, health records, maternal and child health, mental health and social services, pharmacy services, nursing services, and nutrition and dietetics.

Division of Managed Care (GAB2).  (1) Serves as the primary source of technical and policy advice for IHS, and Area Offices and IHS direct, tribal, and urban public health programs on the full scope of clinical health programs, including their quality assurance and preventive aspects, managed care services, third party collections and reimbursements, health care facility accreditation, risk management and quality assurance; (2) administers and implements guidelines for the IHS contract health services (CHS) program including funds management, alternate resources, the Catastrophic Health Emergency Fund (CHEF), claims adjudication, and manages the national IHS payment policy with a fiscal intermediary; (3) provides leadership at a national and State level for Medicare and Medicaid and the private insurance sector; (4) serves as liaison with the Health Care Financing Administration for rate setting; (5) performs analytical studies to address managed care issues; (6) serves as the focal point regarding Medicaid and Medicare managed care activities, including the review, evaluation, and monitoring of sections 1115 and 1915(b) Medicaid waiver proposals and other State and Federal health care reform activities; and (7) assures training on negotiation of provider agreements for Medicaid and private insurance network provider participation.

Division of Community and Environmental Health (GAB3).  (1) Serves as the primary source of technical and policy advice for IHS Headquarters and Area Offices on the full scope of preventive, community, and environmental health programs and health data issues; (2) provides leadership in identifying and articulating preventive, community, and environmental health needs of AI/AN populations and supports efforts to build tribal capacity; (3) advocates for preventive, community, and environmental health care providers; (4) provides and directs public health surveillance, intervention and evaluation programs and the information systems to support them; (5) maintains, analyzes, makes accessible, and publishes results from national program databases; (6) performs statistical and epidemiological consultation for the IHS in response to special conditions and communicable disease outbreaks of public health significance; and (7) performs functions related to public health programs such as environmental health, injury prevention, institutional environmental health, chronic disease prevention, infectious disease control, public health nursing, public health education, HeadStart, dental public health, community health representatives, and nutrition.

Division of Facilities and Environmental Engineering (GAB4).  (1) Serves as the primary source of technical and policy advice for IHS Headquarters and Area Offices, and IHS direct, tribal, and urban public health programs on the full scope of health care and sanitation facilities construction and management, environmental engineering, and realty services management; (2) develops objectives, priorities, standards, and methodologies for the conduct and evaluation of environmental and facilities engineering activities; (3) maintains needs based workload methodology for equitable resource distribution; and (4) provides leadership, consultation, and staff development to assure functional and well maintained health care facilities, and the availability of water, sewer, and solid waste facilities.

Environmental Engineering Branch (GAB41).  (1) Develops, implements, and manages the environmental engineering programs of the agency including the Sanitation Facilities Construction (SFC) program and compliance with environmental protection and historic preservation legislation; (2) provides agency-wide management assistance, and special support and consultation, to address special environmental public health problems, for environmental/engineering construction activities and, for compliance with environmental legislation; (3) develops, implements, and evaluates agency program activities, objectives, policies, plans, guidelines, and standardized data systems for SFC activities; (4) consults with tribal groups/organizations in the development and implementation of SFC policies and initiatives; (5) maintains a national inventory of past and present projects to address those needs; and (6) allocates financial and personnel resources nationwide based on need and workload using the national data inventories.

Facilities Program Development Branch (GAB42).  (1) Develops and coordinates program policy for health care facilities; (2) provides support in the development of budget and program justification; (3) maintains construction priority systems for health care support facilities; and (4) maintains health care facilities planning systems.

Facilities Engineering Branch (GAB43).  (1) Implements program policy and provides consultation on facilities planning, engineering, acquisition, and management; (2) serves as principal resource in providing leadership, guidance, and coordination of facilities management and engineering activities for the IHS, Area Offices, and IHS direct, tribal and urban public health programs; (3) develops and evaluates technical standards and guides; (4) monitors new construction activities and the improvement, repair, and alteration of health care supporting facilities; and (5) formulates financial resources allocation nationwide based on need and workload.

Engineering Services Branch (Dallas) (GAB44).  (1) Administers facilities engineering and construction for specified Area Offices; (2) carries out management activities relating to IHS-owned and utilized facilities; (3) serves as the source of expertise on assigned programs and as liaison with IHS Headquarters on technical programmatic areas; (4) assists in the development, implementation, and monitoring of Area Office annual workplans related to assigned projects including setting objectives responsive to national and Area priorities and assigns office resources required to attain these objectives; and (5) coordinates the development and consultation of cross-cutting objectives.

Engineering Services Branch (Seattle) (GAB45).  (1) Administers facilities engineering and construction for specified Area Offices; (2) carries out management activities relating to IHS-owned and utilized facilities; (3) serves as the source of expertise on assigned programs and as liaison with IHS Headquarters on technical programmatic areas; (4) assists in the development, implementation, and monitoring of Area Office annual workplans related to assigned projects, including setting objectives responsive to national and Area priorities and assigns office resources required to attain these objectives; and (5) coordinates the development and consultation of cross-cutting objectives.

IHS Area Offices (GF)  An Area Office is a bureau-level organization under the direction of an Area Director, who reports to the Director, IHS.  Each Area Office carries out the mission of the IHS by providing a system of health care unique to the Area population.  Area Office Directors supervise clinical directors, who administer programs of direct care to the Area population.  The following are the Area Offices of the IHS:

 Aberdeen Area Office (GFA);
 Alaska Area Office (GFB);
 Albuquerque Area Office (GFC);
 Bemidji Area Office (GFE);
 Billings Area Office (GFF);
 California Area Office (GFG);
 Nashville Area Office (GFH);
 Navajo Area Office (GFJ);
 Oklahoma City Area Office (GFK);
 Phoenix Area Office (GFL);
 Portland Area Office (GFM), and
 Tucson Area Office (GFN).

The specific functions of the IHS Area Offices vary, however, each Area Office includes functions organized to support major categories of administrative management and clinical activities, such as:

Administration and Management - Financial management, administrative and office services, contract/grant administration, procurement, personnel management, facilities management, management information systems, contract health care services, and equal employment opportunity;

Program Planning, Analysis and Evaluation Programs - Program planning, statistical analysis, legislative initiatives, research and evaluation, health records, management information systems, and patient registration/third party collection;

Tribal Activity Programs - Provision of Public Law 93-638, Indian Self-Determination and Educational Assistance Act, health services delivery, community health representative services, urban health, alcoholism and substance abuse, and health education;

Health Programs - Primary care, clinical activities, mental health, nursing services, dental services, health promotion and disease prevention, professional recruitment and community services and the Joint Commission on Accreditation of Healthcare Organizations;

Environmental Health/Sanitation Facilities Construction Programs - Environmental health and engineering/sanitation facilities construction programs for IHS Area Office, and

Information Resources Management Programs - Automated data processing (ADP), ADP planning and operations, management information systems, office automation systems, voice and data telecommunications management.


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